Xelmet XR
Generic Name
Metformin Hydrochloride Extended Release
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| xelmet xr 500 mg tablet | ৳ 7.00 | ৳ 49.00 |
| xelmet xr 1000 mg tablet | ৳ 10.00 | ৳ 70.00 |
Description
Overview of the medicine
Xelmet XR is an oral antidiabetic drug used to improve blood sugar control in adults with type 2 diabetes mellitus. It is an extended-release formulation of Metformin Hydrochloride.
Uses & Indications
Dosage
Adults
Initial dose is typically 500 mg or 750 mg once daily with the evening meal. Dose may be increased gradually in increments of 500 mg weekly to a maximum of 2000 mg or 2500 mg once daily, depending on formulation and patient response.
Elderly
Lower initial dose recommended, with careful monitoring of renal function due to potential age-related decline in kidney function.
Renal_impairment
Contraindicated in severe renal impairment (eGFR <30 mL/min/1.73m²). Dose adjustment required for moderate impairment (eGFR 30-60 mL/min/1.73m²).
How to Take
Take orally, once daily with the evening meal. Swallow the tablet whole; do not crush, chew, or break it.
Mechanism of Action
Metformin works by reducing hepatic glucose production, decreasing intestinal absorption of glucose, and improving insulin sensitivity by increasing peripheral glucose uptake and utilization. Unlike sulfonylureas, it does not stimulate insulin secretion and, therefore, does not cause hypoglycemia in monotherapy.
Pharmacokinetics
Onset
Gradual, full therapeutic effect may take several weeks.
Excretion
Excreted unchanged in the urine, primarily via renal tubular secretion. Renal clearance is approximately 3.5 times higher than creatinine clearance.
Half life
Approximately 4-9 hours (plasma elimination half-life) for immediate-release; extended-release formulations prolong effective half-life.
Absorption
Slowly and incompletely absorbed from the gastrointestinal tract; bioavailability is about 50-60%. Extended-release formulation provides prolonged absorption.
Metabolism
Not metabolized in the liver.
Side Effects
Contraindications
- Severe renal impairment (eGFR <30 mL/min/1.73m²)
- Metabolic acidosis (including diabetic ketoacidosis), with or without coma
- Acute or chronic metabolic acidosis
- Hypersensitivity to Metformin
- Acute heart failure
- Severe dehydration
- Severe infection
- Acute alcohol intoxication
- Hepatic impairment
Drug Interactions
Cimetidine
May increase Metformin plasma concentration.
Corticosteroids
May reduce the glycemic control effect of Metformin.
Iodinated contrast agents
Temporary discontinuation of Metformin before or at the time of the procedure is recommended, especially in patients with impaired renal function.
Diuretics (e.g., Furosemide)
May increase the risk of lactic acidosis.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Overdose of Metformin can lead to lactic acidosis, which is a medical emergency. Symptoms include severe nausea, vomiting, abdominal pain, muscle pain, malaise, and difficulty breathing. Management involves supportive care and hemodialysis to remove Metformin.
Pregnancy & Lactation
Pregnancy: Metformin is generally considered category B. Consult a doctor. Insulin is usually preferred for diabetes management during pregnancy. Lactation: Metformin passes into breast milk in small amounts. Use with caution and consult a doctor.
Side Effects
Contraindications
- Severe renal impairment (eGFR <30 mL/min/1.73m²)
- Metabolic acidosis (including diabetic ketoacidosis), with or without coma
- Acute or chronic metabolic acidosis
- Hypersensitivity to Metformin
- Acute heart failure
- Severe dehydration
- Severe infection
- Acute alcohol intoxication
- Hepatic impairment
Drug Interactions
Cimetidine
May increase Metformin plasma concentration.
Corticosteroids
May reduce the glycemic control effect of Metformin.
Iodinated contrast agents
Temporary discontinuation of Metformin before or at the time of the procedure is recommended, especially in patients with impaired renal function.
Diuretics (e.g., Furosemide)
May increase the risk of lactic acidosis.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Overdose of Metformin can lead to lactic acidosis, which is a medical emergency. Symptoms include severe nausea, vomiting, abdominal pain, muscle pain, malaise, and difficulty breathing. Management involves supportive care and hemodialysis to remove Metformin.
Pregnancy & Lactation
Pregnancy: Metformin is generally considered category B. Consult a doctor. Insulin is usually preferred for diabetes management during pregnancy. Lactation: Metformin passes into breast milk in small amounts. Use with caution and consult a doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from manufacturing date
Availability
Available in pharmacies nationwide
Approval Status
Approved for type 2 diabetes
Patent Status
Generic drug (Metformin)
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established the efficacy and safety of Metformin in type 2 diabetes management. Specific trials for Xelmet XR focus on bioequivalence and extended-release properties.
Lab Monitoring
- Renal function (eGFR) should be assessed before initiating Metformin and at least annually thereafter. More frequent monitoring is needed in elderly or renally impaired patients.
- HbA1c levels should be monitored every 3-6 months.
- Vitamin B12 levels should be measured periodically, especially in patients with risk factors for B12 deficiency.
Doctor Notes
- Emphasize the importance of renal function monitoring, especially in elderly and high-risk patients.
- Educate patients on symptoms of lactic acidosis and Vitamin B12 deficiency.
- Reinforce lifestyle modifications as cornerstone of diabetes management.
Patient Guidelines
- Take medication exactly as prescribed.
- Do not crush, chew, or break extended-release tablets.
- Maintain a balanced diet and regular exercise as advised by your doctor.
- Report any unusual symptoms, especially severe gastrointestinal issues or signs of lactic acidosis.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Xelmet XR alone does not typically cause hypoglycemia, so it generally does not affect the ability to drive or operate machinery. However, if used in combination with other antidiabetic agents that can cause hypoglycemia, caution is advised.
Lifestyle Advice
- Adopt a healthy diet low in refined sugars and saturated fats.
- Engage in regular physical activity.
- Maintain a healthy weight.
- Limit alcohol consumption.
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